Proctoscopy uses a small lighted tube to directly visualise internal piles and assign grade. Takes 2 minutes, causes pressure not pain. The gold standard for piles diagnosis.
What Is Proctoscopy and Why Is It Used for Piles?
Proctoscopy is a brief in-clinic examination where a proctoscope — a hollow, rigid, lighted tube approximately 15 cm long and 2–3 cm in diameter — is gently inserted into the anal canal to directly visualise the internal anal canal and lower rectum.
For piles patients, proctoscopy is the gold standard diagnostic tool because:
- Internal haemorrhoids cannot be seen externally
- Anoscopy (a shorter 7 cm scope) visualises only the anal canal; proctoscopy sees 10–15 cm higher
- Grade I–III internal piles can be directly seen, identified, measured and graded
- Active bleeding points can be identified
- Coexisting conditions (fissure, polyps, proctitis) can be identified simultaneously
What Happens During Proctoscopy
**Preparation:** No bowel preparation is generally needed for a proctoscopy at a proctology clinic. Patients may be asked to empty the rectum naturally before the appointment.
**Position:** The patient is placed in the left lateral (Sim's) position — lying on the left side with knees drawn toward the chest.
**Procedure:** 1. The proctoscope is lubricated and gently inserted with slow, continuous pressure — not sudden force 2. Once fully inserted, the inner obturator is removed, opening the view 3. The doctor inspects the mucosa as the scope is slowly withdrawn 4. Internal haemorrhoids appear as purple-red cushion-like projections during straining 5. The scope is fully removed — the procedure is complete
**Time:** 2–5 minutes total. Most patients are surprised at how brief it is.
**What it feels like:** Pressure and a feeling of fullness — similar to the urge to pass stool. Not typically painful unless there is active infection or fissure.
Is Preparation Needed Before Proctoscopy?
- No dietary change is required
- No laxative preparation is usually needed
- An enema may occasionally be requested if the rectum is very full
- Normal meals can be eaten on the day
Frequently Asked Questions
**Q: Is proctoscopy the same as colonoscopy?** A: No. Proctoscopy visualises the lower 15 cm of the rectum. Colonoscopy visualises the entire colon (150+ cm) and requires full bowel preparation. Proctoscopy is far shorter, requires no preparation and is an in-office procedure.
**Q: Should I fast before proctoscopy?** A: Generally no. Confirm with your specific clinic, as some may have minor preparation instructions.
Book a Proctoscopy at RectoRelief Hospital
Same-day proctoscopy with immediate diagnosis and treatment planning available at RectoRelief Hospital, Noida.